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Prediction of percutaneous nephrolithotomy outcomes and flexible ureteroscopy outcomes using nephrolithometry scoring systems

  • Urology - Original Paper
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Abstract

Background

Kidney stones account for a high proportion of urological emergencies. The main objective of this paper is to evaluate the predictive ability of five scoring systems for overall stone-free status and postoperative complications after percutaneous nephrolithotomy and retrograde ureteroscopy.

Materials and methods

This study retrospectively analysed 312 cases of kidney stone patients between January 2021 and May 2022 at our centre. Multivariate logistic regression as well as ROC curves were applied to determine the ability to evaluate each scale to predict stone-free rates and postoperative complications.

Results

179 patients have undergone PCNL. After multivariate logistic regression, the S.T.O.N.E score and history of ipsilateral renal surgery were predictive of stone-free status, and the predictive power of the S.T.O.N.E score was higher than that of history of ipsilateral renal surgery. Grade 1 complications were considered to be related to Guy’s score and grade 2 complications were considered to be related to history of diabetes mellitus. 133 patients have undergone f-URS. After multivariate logistic regression analysis, the modified S-ReSC score, RUSS score, and R.I.R.S score were predictive of stone-free status, with the R.I.R.S score being the strongest predictor. Evidence of grade 2 complications was considered to be related to abnormal renal function.

Conclusion

For PCNL, the S.T.O.N.E score had the best efficacy in predicting stone-free status, and the Guy's score had the best efficacy in predicting postoperative complications; for f-URS, the R.I.R.S score had the best efficacy in predicting stone-free status, and no scoring system predicted postoperative complications.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Abbreviations

AUC:

Area under curve

BMI:

Body mass index

PCNL:

Percutaneous nephrolithotomy

ROC:

Receiver operating characteristic

SFR:

Stone-free rate

F-URS:

Flexible ureteroscopy

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Acknowledgements

We thank all other researchers in our laboratory for their valuable help in our work.

Funding

This study was supported by the National Natural Science Foundation of China (82070724) and the Natural Science Foundation of Anhui Province (1908085MH246).

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Author notes

  1. Qiushi He and Qingfeng Huang have been contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

    Qiushi He, Qingfeng Huang, Bingbing Hou & Zongyao Hao

  2. Institute of Urology, Anhui Medical University, Hefei, China

    Qiushi He, Qingfeng Huang, Bingbing Hou & Zongyao Hao

  3. Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China

    Qiushi He, Qingfeng Huang, Bingbing Hou & Zongyao Hao

Authors
  1. Qiushi He
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  2. Qingfeng Huang
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  4. Zongyao Hao
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Contributions

ZYH: conceptualization, methodology and project administration; QSH and QFH: visualization, investigation, software and writing–review and editing; QSH, QFH and BBH: software and data collection. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zongyao Hao.

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He, Q., Huang, Q., Hou, B. et al. Prediction of percutaneous nephrolithotomy outcomes and flexible ureteroscopy outcomes using nephrolithometry scoring systems. Int Urol Nephrol 56, 1585–1593 (2024). https://doi.org/10.1007/s11255-023-03847-z

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